Articles: disease.
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Dtsch. Med. Wochenschr. · Feb 2020
[Glomerulonephritis, diseases not only important for nephrologists].
Chronic kidney disease (CKD) is an increasing health problem in all societies. The role of diabetes mellitus and hypertension in CKD is well established in the medical community. This is not necessarily the case for the various forms of glomerulonephitis (GN). ⋯ Since many forms of GN have only sparse clinical symptoms at the beginning of the disease and the treatment is only effective in early stages, it is important for patients' outcome to make an early diagnosis. In case of any - even small - changes in the urine of patients the diagnoses of GN should be considered. It is the purpose of this article to describe the clinical significance and the road to the diagnosis of the most frequent forms of GN to allow an early start of therapy in order to prevent the development of ESRD.
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Improving chronic obstructive pulmonary disease (COPD) care and reducing hospital readmissions is an urgent healthcare system priority. However, little is known about the organizational factors that underlie intersite variation in readmission rates. Evidence from other chronic diseases points to care coordination as one such factor. ⋯ The most notable differences between high- and low-readmission sites were related to the quality of relational coordination and the presence of structural barriers to coordination, rather than specific readmission reduction initiatives. Implementing organizational reforms aimed at enhancing relational coordination and removing structural barriers would enhance care for COPD and may improve quality of care for other chronic conditions.